Azithromycin for skin boils: what to know

A clinician chooses an antibiotic according to the boil's appearance, severity, location, previous treatment and, when available, a sample of the pus. Some bacteria that cause boils may not respond to azithromycin, so do not use leftover tablets or another person's prescription.

A boil is a tender, pus-filled infection that develops around a hair follicle. Antibiotics travel through the bloodstream, but a sealed pocket of pus can be difficult to clear with medicine alone. A large, soft or very painful boil may need a clinician to open and drain it.

Antibiotics are more likely to be considered when infection is spreading into nearby skin, several lesions are present, the person feels unwell, immunity is reduced, or the boil has not improved after drainage. Repeated boils may prompt a pus sample or an assessment for another underlying skin problem.

Take azithromycin exactly as directed and complete the prescribed course unless the prescriber tells you to stop. Check the label for instructions about food, missed doses and other medicines. Tell the prescriber about previous antibiotic reactions, liver problems, an irregular heartbeat and every medicine or supplement you take.

Keep the area clean and covered if it drains, wash your hands after touching the dressing, and avoid sharing towels or razors. A warm, clean compress may ease discomfort and encourage natural drainage. Do not squeeze, pierce or cut the boil yourself because this can push infection into surrounding tissue.

Contact the prescriber if the boil enlarges, pain or redness worsens, new boils appear, or there is no clear improvement during the expected follow-up period. The clinician may need to drain it, take a sample, or change the antibiotic.

Arrange prompt medical assessment for a boil on the face or near the eye, rapidly spreading redness, red streaks, marked swelling, fever, chills, dizziness, confusion, or severe worsening pain. Seek earlier care if you have diabetes, reduced immunity, or take medicines that suppress the immune system.

Get urgent help after azithromycin if you develop trouble breathing, swelling of the lips, tongue or throat, fainting, or a widespread blistering rash. Severe or persistent watery diarrhoea, yellowing of the skin or eyes, or a new fast or irregular heartbeat also needs prompt medical advice.

Ask whether the lump is a boil, whether it needs drainage, and why azithromycin is appropriate for the likely bacteria. You can also ask whether a pus sample is useful, what improvement should look like, which adverse effects require a call, and when the area should be checked again.